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Next-Generation MRI Applied to Degenerative Cervical Myelopathy

(2016)Lange, S. (Stefan)

Degenerative Cervical Myelopathy is a progressive degenerative disease affecting millions of people worldwide. DCM encompasses age related disorders as CSM, OPLL, OLF, and others. Patients are classified as mild, moderate, and severe, of which the mild group is the most interesting one. Currently, there is no consensus on the treatment of this group, with some medical professionals pursuing surgical treatment, while others prefer the watchful waiting approach. Advanced MRI techniques might have a solution for this dilemma. We hope to proof that evaluation of microstructural integrity through quantitative MRI can aid surgical decision making and optimize the allocation of resources. We enrolled 56 DCM patients and 32 healthy controls. Both groups underwent clinical evaluation and MRI assessment using T2-weighted imaging, DTI, MT, and T2*-weighted imaging. The patients underwent follow up-assessment one year after surgery in the surgical cohort, and one year after initial assessment in the non-surgical cohort. We found significant differences between healthy subjects and DCM patients for most MRI metrics. We found moderately strong correlations between the recovery ratio and magnetization transfer ratio, and between white matter-grey matter ratio and the progression ratio. Other metrics proved insignificant after 22 patients underwent follow up-assessments. Advanced MRI techniques have the potential to aid clinical decision making, but so far results are inconclusive. Development of these techniques has the potential to aid the development of regenerative medicine in spinal cord injury, but more follow up-assessments are needed before definitive conclusions can be made.